More Adverse Reactions to Sulfa Antibiotics in Patients w/Lupus than Those w/Other Inflammatory Arthritic Diseases

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More Adverse Drug Reactions to Sulfa Antibiotics in Patients with Systemic

Lupus Erythematosus than in Those with Other Inflammatory Arthritic Diseases

Journal of Rheumatology 2003;30:480-484.

A DGReview of :"Frequency of Adverse Drug Reactions in Patients

with Systemic Lupus Erythematosus"

Patients with systemic lupus erythematosus (SLE) appear to have more

adverse drug reactions than those with other inflammatory arthritic

disease, contrary to previous research findings, Canadian researchers

report.

A case controlled study at the universities Toronto and Western Ontario

compared the prevalence of adverse drug reactions (ADR) among

patients with SLE and controls with inflammatory arthritis.

The researchers surveyed 145 patients with SLE and 104 age and gender

matched controls with other inflammatory arthritic diseases, including

rheumatoid arthritis, probable rheumatoid arthritis and psoriatic arthritis.

The two groups were drawn from a single rheumatology practice and had

similar characteristics and drug exposures.

Patients were questioned on exposure and ADR to five classes of drugs.

These included (1) beta lactams, (2) sulphonamides, (3) other antibiotics,

(4) disease modifying anti-rheumatic drugs (DMARDs), and (5)

nonsteroidal anti-inflammatory drugs (NSAIDs). They also were asked to

provide family and personal histories of atopy.

Response rate was 63% in the SLE group and 64% in the controls. Of

these, 99% with SLE and 88% of controls were females. Both groups had

similar exposure to all antibiotics and NSAIDs. Patients with SLE had little

previous exposure to DMARDs, with the exception of plaquenil and

azathioprine.

There were some differences between the groups relative to certain

medications. Of patients exposed to sulfa antibiotics, SLE patients had

25/48 reactions compared to 6/31 in the controls (P<0.003), but no

differences with other medications. Most of the ADRs to sulfa antibiotics

were cutaneous.

Patients with an atopic or allergic history had more ADRs (P<0.0005),

but

there were no differences between groups according to family history

(P<0.88). Those subjects who had a family history of allergies were

more

likely to have ADRs (P<0.0043).

Finally researchers concluded that patients with SLE and controls with

similar personal versus family history of environmental allergies did not

differ in suffering adverse drug reactions (P<0.16 and P<0.83

respectively). They did question, however, whether there could be

differences in the pharmacogenetics, since their own sample population

was mainly Caucasian.